Provider Demographics
| NPI: | 1316807399 |
|---|---|
| Name: | JEDA CARE GROUP LLC |
| Entity type: | Organization |
| Organization Name: | JEDA CARE GROUP LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DANIEL |
| Authorized Official - Middle Name: | JESUTONI |
| Authorized Official - Last Name: | ADERIBIGBE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 404-667-1693 |
| Mailing Address - Street 1: | 2299 ARGENTO CIR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | DACULA |
| Mailing Address - State: | GA |
| Mailing Address - Zip Code: | 30019-2834 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 404-667-1693 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2299 ARGENTO CIR |
| Practice Address - Street 2: | |
| Practice Address - City: | DACULA |
| Practice Address - State: | GA |
| Practice Address - Zip Code: | 30019-2834 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 404-667-1693 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2025-11-13 |
| Last Update Date: | 2025-11-13 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251E00000X | Agencies | Home Health | |
| No | 251J00000X | Agencies | Nursing Care | |
| No | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 253Z00000X | Agencies | In Home Supportive Care | |
| No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
| No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness |
| No | 3104A0630X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Behavioral Disturbances |
| No | 3140N1450X | Nursing & Custodial Care Facilities | Skilled Nursing Facility | Nursing Care, Pediatric |
| No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | |
| No | 385H00000X | Respite Care Facility | Respite Care | |
| No | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child |
| No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |
| No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |
